Hi, Lactnetters

Ellen Vegh writes:

>Assuming there are not other signs of anything amiss, lots of leaking in
>and of itself does not mean anything is wrong.It is one of those things
>that is basically a laundry problem, like spitting up usually is.

I'm not so sure that leaking should just be considered a laundry problem, if
for no other reason than that laundry problem is just annoying enough to
some moms to make them quit breastfeeding. It seems to me that leaking is
more of a protective mechanism that happens because something is not quite
right, or at least not optimal. Riordan and Auerbach call it a "safety
valve" and note that "many women with recurring mastitis often report never
having spontaneously dripped or leaked milk" (BF and Human Lactation). This
doesn't necessarily mean that if a mom does NOT leak she will end up with
mastitis, only that if the "safety valve" isn't functional that there could
be a problem. Like a safety valve on a steam pipe, it isn't supposed to just
leak routinely--only when there is a problem.

Leaking in a new mom can often be attributed to her body's attempt to get in
sync with her baby's demand for her milk. If she's making the "right"
amount, she is less likely to leak. And even the dripping of milk as a new
baby is learning to breastfeed may just be a way of encouraging a tiny baby
to remember what he's there for!

Another major time we hear of moms leaking is when she's out and about and
hears a baby cry and her letdown kicks in. That's protective as well--a baby
needs his mom and that need is strong enough to sometimes trigger the
letdown in the wrong mom! And if mom is away from baby and has a letdown, at
least from the standpoint of Mother Nature, she isn't intended to be away
from her baby in the first place.

I think a lot of the leaking that happens with older babies can be helped by
feeding from one breast per feeding, or at least allowing baby to finish one
breast before going on to the next. By getting more of the fattier hindmilk
baby doesn't need as much milk to get his calories, and by taking less milk,
the breast makes less, and by making less milk (yet still what baby needs)
she is less likely to trigger the safety valve.

If a mom comes to me and mentions she is leaking, then it is enough of a
problem to be a nuisance. Telling her it is a laundry problem can at least
put her mind at ease that there isn't a major problem (although there are
some medical conditions that could cause leaking), but I think we can also
go beyond this and tell her that it may mean that a little refinement would
help with the leaking. Fine tuning, if you will.

I don't think we are "supposed" to leak. I think we are supposed to be ABLE
to leak.
Just my two cents (or more!!!) worth!

Melissa Vickers, IBCLC
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